title: Large-diameter (30-35 mm) pneumatic balloon dilatation of the pylorus in patients with gastric outlet obstruction symptoms after esophagectomy.
abstract: OBJECTIVE
  Functional gastric outlet obstruction is a common problem after esophagectomy. The aim of this study was to evaluate the safety and efficacy of treating this group of patients with pneumatic dilatation of the pyloric sphincter region using a large-diameter (30-35 mm) balloon.
  
  
  METHODS
  A review of all patients who had undergone pneumatic dilatation of the pylorus sphincter because of gastric outlet obstruction symptoms after esophagectomy at the Karolinska University Hospital from 2006-2011 was completed. Main outcomes were recordings of nausea, regurgitation and bloating.
  
  
  RESULTS
  A total of 13 patients received pneumatic dilatation after an esophagectomy. The median time between esophagectomy and the first dilatation was 100 days, and the patients underwent a total of 21 dilatations (1-3 per patient) to a final median diameter of 30 mm. No procedure-related complications occurred. The median follow-up time was 205 days, and nausea and regurgitation improved significantly (p < 0.001, Fisher's test).
  
  
  CONCLUSIONS
  Pneumatic dilatation of the pylorus using a large-diameter pneumatic balloon seems to be a safe and effective method for treating symptoms suggestive of gastric outlet obstruction after esophagectomy. To document its true effectiveness, a randomized and sham-controlled study is needed.
authors.affiliation: Division of Surgery, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Ericson
authors.forename: B
authors.initials: B
authors.lastname: Sunde
authors.forename: M
authors.initials: M
authors.lastname: Lindblad
authors.forename: M
authors.initials: M
authors.lastname: Nilsson
authors.forename: L
authors.initials: L
authors.lastname: Lundell
authors.forename: J A
authors.initials: JA
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D004106:Dilatation / Q000295:instrumentation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011708:Pylorus; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Esophagectomy; balloon dilatation; endoscopy; gastric outlet obstruction; pylorus; vagus nerve diseases